Chancre. Syphilitic chancre: features of the disease

When diagnosing syphilis in a victim, experts mean venereal disease chronic course, affecting the skin and mucous membranes of the body, internal organs, bone tissue, and the central nervous system. The formation of the disease is provoked by a pale spirochete, which, being outside the human body, is characterized by weak resistance to alcohol, soapy water, high temperature conditions. At the same time, syphilis is a very dangerous condition, since the causative agent of the disease is able to penetrate into human body through damage even invisible to the eye.

Pathology transmission routes

Let's look at syphilis and its spread. It is not for nothing that the disease is called a venereal disease, since the disease is transmitted from the carrier to the victim, with the exception of only 5% of cases through sexual contact. In this case, infection occurs not only during vaginal contact, but also during anal and oral intercourse. Syphilis can also be:

• Household - this form is extremely rare, since even if treponema gets on personal hygiene items, it quickly dies.
• Congenital (observed in infants) - infection occurs either during gestation or during labor activity. The lactation period is also quite dangerous if the mother is sick with syphilis.
• Another rare method is blood transfusion. Modern medicine carefully examines donors; moreover, when the substance is preserved, the pathogen dies within five days. Increased danger represents only direct transfusion from the carrier, which occurs infrequently.

But even if contact with a carrier has taken place, manifestations of syphilis may be absent in 20% of cases - infection does not occur because the necessary conditions for this do not exist. In particular, the amount of viral agents in an infected biomaterial can be very small; the absence of microtrauma or individual immunity plays a role. The risk of infection increases when the patient has primary or secondary syphilis, accompanied by erosive and weeping elements of pathological rashes. If we are talking about late pathology - latent or tertiary - infection occurs very rarely during contact with a carrier.

Since a syphilitic rash can form in any area of ​​the skin or mucous membrane, condoms cannot be considered reliable protection, they only reduce the risk of infection, also protecting against urogenital infections that usually accompany the underlying disease.

As for how long it takes for syphilis to manifest itself, it is important to have an idea incubation period. On average, its duration is from three to four weeks, but the interval may decrease to two weeks or increase to six months if taken by the victim for any reason. antimicrobials. It should be understood that even in the case of active development of pathology, symptoms may be absent at first. Laboratory tests can determine the presence of the disease only two to four weeks after its primary period begins. Accordingly, all partners of the carrier who had sexual contact with him during this period are at risk of infection, hence the need to test for syphilis.

How does the disease begin to manifest itself?

Standard primary signs of pathology - formation chancre along with an increase in the size of the lymph nodes. A chancre is an ulcer or erosive lesion of a round shape, distinguished by clear boundaries. Usually it has a red tint, secretes a serous substance, thus acquiring a “varnished” appearance. The secretions contain increased amount pathogens of the disease, when examining the liquid they can be detected even in cases where in the blood at laboratory tests there is nothing suspicious. The base of the chancre is hard, its edges are slightly raised, forming a shape similar to a shallow saucer. Syphiloma is usually not accompanied by pain or other uncomfortable symptoms.

There are many places for the formation of syphiloma - it can be the genitals, mouth or anus, it all depends on the type of sexual contact. The formation of primary symptoms occurs in stages:

• From the moment the pathogen enters the body until the symptom is formed, it usually takes from two to six weeks.
• Enlargement of the lymph nodes that are located closest to syphiloma usually begins after seven days.
• After another three to six weeks have passed, the ulcers heal, so visible symptoms are missing.

There are also a number additional signs, which accompany the formation of chancre, in this case the first manifestations include:

• problems with sleep, development of insomnia;
• fever ( elevated temperature body);
• headache and joint pain, bone discomfort;
• general malaise;
• swelling of the genitals.

Atypical symptoms of the pathology include the appearance of amygdalitis chancres in areas of the tonsils, the formation of chancre-felons on the fingers, indurative swelling in the labia area, regional lymphadenitis and lymphangitis.

Clinical periods of pathology

When characterizing syphilis, we can classify it as a systemic pathology that can affect the entire body. External clinical manifestations are often similar to symptoms characteristic of other diseases; therefore, accurate diagnosis includes laboratory tests of the skin and blood sampling for the Wasserman reaction. What specific symptoms of the pathology will appear in the victim largely depend on a number of factors, including his age category, lifestyle, immune system, and other individual characteristics.

The development of syphilis occurs in three periods - primary, secondary, tertiary. They are preceded by a three-week asymptomatic incubation period. Let's consider how syphilis manifests itself in different periods formation.

We discussed the incubation and primary periods above. Perhaps we should add that during the incubation period the carrier is not infectious, so the Wasserman reaction will show negative result. As for primary syphilis, at this stage of the development of the disease the patient becomes infectious. Now about chancre - its disappearance occurs without any treatment, and a scar is formed at the site of syphiloma. At this stage it is necessary to show increased attention– even in the case when the chancre completely disappears, we cannot talk about healing, since the development of the disease continues.

After the treponemes enter the lymph nodes, they are carried throughout the body along with the bloodstream. About availability primary period pathology can indicate both unilateral and bilateral enlargement of lymph nodes, usually observed in groin area. They are distinguished by their dense elastic consistency, mobility and painlessness. In the first half of this period, the Wasserman reaction, along with other blood tests, continued to remain negative. However, in the second half of the period - usually the sixth or seventh week from the onset of infection - blood tests show a positive result, revealing the presence of syphilis in the body. The above weakness, fever and pain occur at the end of primary stage syphilis - these signs can be considered harbingers of the formation of a generalized rash, which marks the beginning of the secondary stage of the pathology.

About ten weeks after infection of the body - which implies the typical development of pathology with syphilis - signs appear on the skin indicating a fresh secondary stage of the disease. We are talking about a syphilitic rash, including pustules and spots, nodules. None of the listed elements cause discomfort. The rash disappears after a few weeks without requiring any treatment. medicines. After it passes, we can talk about the onset of secondary latent syphilis. It is characterized by certain manifestations, including:

• syphilitic rash;
• hair loss;
• discolored spots on the skin of the neck;
• positive Wasserman reaction along with other tests carried out.

Any of the elements of the rash at this stage are highly contagious, but completely painless.

Features of the secondary period of syphilis - increased risk regarding the possibility domestic infection. The duration of this stage is usually from two to four years.

Let's see how tertiary syphilis manifests itself. Typically, this stage occurs five or more years after infection. The main features characterizing the tertiary stage include:

• The formation of gummas - foci - in bone tissue, skin, liver and brain, lungs and heart muscle and even eyes. Gummas are subject to decay, resulting in the destruction of the area in which they were formed.
• The appearance of ulcers on the mucous layers of the palate and back of the pharynx and nasal cavity.
• Possible damage to the nasal septum and its gradual destruction.
• The symptoms of this stage are closely related to the destruction nerve cells both the spinal cord and the brain, they manifest themselves in dementia and the appearance of progressive paralysis.

At this time, visible lesions practically do not include the pallidum spirochete, and accordingly they are rarely infectious. When carrying out the Wasserman reaction and other laboratory tests, a weakly positive or negative reaction. Regardless of the syphilitic symptoms, each stage of the pathology is curable. However, at the third stage, the disease not only affects, but can also destroy many human organs, making cell restoration impossible. Quite often in such a case the victim becomes disabled for the rest of his life.

Syphilitic rash is the main symptom of the disease

The main symptom of syphilis is a rash, the appearance of which is not accompanied by unpleasant sensations. At the initial stage of pathology, this is a hard chancre, but it can manifest itself with a variety of elements, from pink spots to papules and pustules. Spots of a centimeter in diameter in gray, blue or red shades may appear on the skin. In this case, all types of rash can form simultaneously, most often localized on the hands or sole of the foot. Usually there is no pain or itching at all. Unpleasant feeling occurs in very in rare cases, when palpating papules.

Considering practically complete absence discomfort, victims often ignore the rash. In addition, it goes away on its own, and therefore therapeutic measures are used with considerable delay. Nevertheless, syphilitic rashes have a number of characteristic signs:

• The rash is copper colored.
• The lesion that accompanies the rash is peeling or the formation of dirty brown, gray scabs.
• The rash can both disappear and reappear - here the ratio of treponema pallidum and antibodies contained in the blood plays an important role.
• If a relapse occurs, the rash can change. It becomes larger, ovals or circles form on the skin and mucous membranes. This development can be observed over a period of four or five years - all the time that secondary syphilis continues.
• In the presence of tertiary syphilis, subcutaneous compactions occur. Their diameter can reach 1.5 cm. Such compactions transform into ulcers over time. Lumps may form on the skin, forming circles, in the center of which appear ulcerative lesions and necrosis forms.

Considering all the dangers of the disease, if suspicious symptoms appear, it is necessary immediate appeal to a venereologist to make an accurate diagnosis and develop a therapeutic regimen.

Symptoms in representatives of the sexes and methods of detection

When comparing the signs of pathology developing in representatives of different sexes, it can be noted that the main differences lie in the localization of foci of syphilis. In men, lesions are concentrated on the scrotum or penis, in women - on the labia minora and vaginal mucosa. If in lovemaking there is anal and oral sex, negative phenomena are concentrated on the sphincter, oral mucosa, throat, lips and tongue. The skin of the neck or chest may be affected.

In the fairer sex, the formation of hard chancre most often occurs on the vaginal walls or on the uterine cervix, in the area of ​​the labia. The problem with defining the disease initial stages development is possible when syphiloma forms on the uterine cervix. Much less often, chancre forms on the chest or in the mouth, on the thighs or in the perineal area. Most often, one chancre is formed, but the formation of two, and sometimes more, syphilomas at once is not an exception.

If you do not pay attention to the symptoms indicating the formation of a problem, syphilis can remain in the body for not just years - decades! At the same time, its course is wavy, and the lesions become dangerous and dangerous over time. difficult character. Is it possible to identify signs of syphilis on your own? Undoubtedly, if you follow a number of existing recommendations:

• If there has been a suspicious contact, the entire body should be thoroughly examined two or three weeks after the contact. During this period, the main attention should be paid to the possibility of forming a painless chancre.
• If a chancre or similar formation is detected, you will need to mentally analyze your condition. In this case, we are talking about primary syphilis, so attention should be paid to fever and rising temperature, headaches, insomnia and muscle pain.
• The next step is palpation of the lymph nodes, first of all the most characteristic ones. Their increase, especially if there is a formation nearby that resembles a chancre, serves possible sign syphilis. When palpated, the lymph nodes should be mobile and elastic, fairly dense, but painless.

To confirm the presence of syphilis, it is necessary to contact a venereologist at the same time when chancre was first discovered - only timely treatment prevents complications of pathology.

Signs of congenital disease

During the process of bearing a child, a woman infected with syphilis can infect the fetus from the tenth week of pregnancy through the placenta. If secondary syphilis occurs, the child is 100% infected, if present later forms pathology, infection does not occur so often. Infection of the fetus occurs most rarely in the case of primary syphilis in the mother. If the fetus is infected with syphilis, the consequences can be catastrophic - the death of the embryo is possible with spontaneous abortion. The possibility of a stillborn child cannot be ruled out. In the case when the baby is nevertheless born, symptoms of congenital pathology are detected in his childhood, depending on when exactly the mother was infected. Congenital pathology may be early or late. The first includes infections of the fetus, infants and young children:

• Fetal syphilis leads to its death in the sixth or seventh month; death occurs due to exposure to toxins of the pathogen.
• When a child is under one year of age, if signs of pathology are visible, we can talk about the baby’s non-viability. Immediately after its birth, a skin lesion occurs - syphilitic pemphigus. Syphilitic runny nose is observed, lesions are often diagnosed bone tissue, spleen or liver. If the brain is affected, meningoencephalitis is formed.
• With congenital syphilis in children from one to five years of age, the signs resemble secondary syphilis, symptoms include syphilitic rash on mucous and skin layers.

With late congenital syphilis, which manifests itself from 5 to 15 years, eye damage is observed, deafness develops, problems appear in internal organs, affects the central nervous system.

Preventive actions congenital syphilis include mandatory tests for the presence of pathology, which is carried out three times during pregnancy. If the result is positive, a visit to a venereologist is necessary - the specialist will decide on the continuation of pregnancy and treatment of the pathology. At increased risk formation of congenital syphilis, pregnancy can be terminated in accordance with medical indications. Women who have had syphilis should plan to conceive no earlier than five years after final healing.

Primary syphilis manifests itself in enlarged lymph nodes andchancre. What is chancre? This symptoms of syphilis, which are round sores with a diameter of about one centimeter on the patient’s body.

They are red and blue in color, sometimes they are painful, but generally the patient does not perceive painful sensations at the site of erosion. First signs syphilis in men: formation of chancre on the head of the penis, and in womensymptoms of syphilisappear on the walls of the uterus and on the external genitalia. These sores also occur on the pubis, near the anus, on the tongue and lips.

Syphilis develops quickly, and the lymph nodes become inflamed and enlarged first, and then the formation chancre.

May resolve on its own, even without drug treatment after, from one month to two. It goes away almost without a trace, although if the ulcers are large, dark spots may remain.

Chancre with syphilis- this is the focus of syphiloma, which is formed at the site of treponema in the body.

Chancre gets its name from French word, which translated means ulcer, erosion. For some infectious diseases there is a chancre, but with syphilis, this erosion is the first sign syphilis in the first stage. Educationchancre,on the body after a little more than 4 weeks from the moment of infection with this disease. During this period, the spirochete infection manages to get into many organs and lymph, and begins to multiply, which causes inflammatory process and maybe temperature appears.

Types of chancre

They are classified according to the type, size, number of ulcers on the body, and their location.

The chancre is divided by type:

• erosive - this is erosion that affects the layers of the mucous system;
• Ulcerative chancre is an ulcer that penetrates into the deep layers of tissue.

According to the quantitative classification, chancre is divided into:

• single is a chancre, which consists of one ulcer;
• multiple is an erosion that consists of many ulcers that create a single wound.

Syphilomas of chancre The sizes are:

• small (dwarf) - diameter less than 10 mm;
• medium - diameter from 20 mm;
• large (giant) - diameter 50 mm and above.

Place of appearance of hard chancre on the body:

• extragenital - the tongue, anus, chest, throat, legs, gums are affected by ulcers;
• genital - these are erosions, emerging on the genitals of a sick person;
• bipolar are chancres that simultaneously appear on the genitals and other parts of the body.

By the end of the primary period of syphilis, chancre becomes a form of the disease that:

• has localization in specific places, in the oral cavity and on the genitals;
• does not have a numerous form;
• does not affect internal organs;
• It is quite easy to treat and leaves no consequences.

Features of the development of chancre

In people who have become infected syphilis infections and at the same time have reduced immunity, ulcerative lesions appears Necessarily. Also, the formation of ulcers on the body occurs due to chronic infections, toxicity of the body and age reasons. Due to self-medication syphilis pustular erosions are formed, which after attenuation leave dark spots and scars.

It begins to develop with redness, which does not cause itching or pain. After 48 to 72 hours, this redness begins to form a bump and a papule. At this point, the epithelium from the chancre may peel off, and the infected person begins to feel pain for the first time.

In the following hours and days, the syphiloma becomes larger, spreading around the circumference. A hard crust begins to form on the papule, under which an ulcer forms. Over time, the crust is rejected and a sign of syphilis appears - chancre.

The shape of the chancre is slightly raised, with clear round edges. Sometimes these edges are oval shape. The surface of the chancre is smooth, sometimes has a grayish coating, but the main color of the chancre is red.

The shape of chancre varies:

• nodule shape - this ulcer has clear boundaries. This ulcer grows into the deep layers of tissue and retains its clear boundaries. This chancre is localized on foreskin penis;
• plate or coin shape - chancre is localized on upper layers tissue and is located on the labia, shaft of the penis, and on the scrotum;
• leaf-shaped - erosion has clear boundary lines and is located mainly on the head of the phallus.

Atypical chancroid

Except hard chancre, there is also atypical chancre and many of its types:

• indurative edema is a large lump that forms on the foreskin of the penis, the genitals in women and in the lip area on a person’s face;
• Panaritium is a chancre that develops on the nails and does not heal for several months. There may even be nail rejection;
• lymph nodes - increase in this period. Depending on which part of the body the chancre formed, the lymph nodes closest to the chancre become inflamed;
• A bubo is a lymph node that has a mobile shape and has no painful signs and is located closest to the chancre: on the patient’s neck, if the chancre is in the tonsils, and in the groin part of the body, if chancre on penis , in the genital area;
• polyadenitis is inflammation and hardening of all lymph nodes, from this moment we can assume that symptoms have begun to appear secondary syphilis.

Complications of syphilis in the first period are very serious both for women and also have serious consequences for the male part of the population.

Chancre in the female body

IN female body occurs:

• on the labia majora and minora;
• on the clitoris;
• on the walls of the cervix;
• in the area between the anus and vagina.

On the walls of the vagina,chancre with syphilisoccurs very rarely, since the acidity of the vagina has a detrimental effect on treponema.

Very often, syphilis chancre forms on the cervix. This chancre is invisible and is diagnosed mainly at the second stage of the disease.

Over 10 percent of women with syphilis in the first stage have a hard chancre on the walls of the cervix. Syphilis chancre is detected only at the time of examination of the uterus using medical equipment. This examination is carried out by a gynecologist or venereologist.

In the oral cavity, chancre forms on the tongue, lips, soft palate and tonsils. There are frequent cases of ulcers on the gums, cheeks, fingers and chest.

Diagnosis of syphiloma

Diagnosis of syphilis consists of several types of examinations and tests:

• serological diagnosis is the detection of Treponema bacteria from scraping of chancre. Based on the results of this examination, the doctor makes a diagnosis;
• Treponema immobilization reaction;
• immunofluorescence reaction;
• Wasserman reaction;
• microreaction on glass;
• linked immunosorbent assay;
• microprecipitation reaction;
• passive hemagglutination reaction.

Relationship between chancre and primary syphilis

Syphilis is a sexually transmitted disease that occurs in a classic form.Syphilis chancroid, main feature this disease. Chancroid is a symptom of primary syphilis only.

Syphilis in the first stage of its development manifests itself in enlarged lymph nodes and chancre. Towards the end of this period the following symptoms appear:

• state of general malaise;
• constant headache;
• elevated temperature;
• pain in muscle tissue;
• aches and pain in the bones;
• decreased hemoglobin;
• significant increase in leukocytes.

Syphilic chancrehas the ability to pass on its own and leave no traces, so people who self-medicate can assume that syphilis has been cured.

This is a misconception, because the disappearance of chancre is preceded by secondary syphilis, which is much more dangerous than syphilis in the first stage of development and treatment of this type is much more complex and lengthy.

Complications of syphilitic chancroid

As complications of syphilitic chancre, other infections may penetrate into the chancre, which leads to painful symptoms and the accumulation of pus in this place.

There are several reasons for infection:

• chancre injury;
• lack of hygiene;
• diabetes mellitus;
• HIV infection;
• development of tuberculosis bacillus in the body.

The female body develops:

• syphilitic gangrene;
• infectious vaginitis;
• inflammatory bartholinitis;
• endocervicitis of the cervix.

Complications in male body lead to:

• balanitis;
• balanoposthitis of the head of the penis;
• phimosis of the foreskin;
• paraphimosis of the foreskin;
• gangrenization of the head of the penis;
• phagedenism of the penis.

Treatment of syphiloma

At the primary stage, the task is to cure the infection and prevent syphilis from moving into the second stage.Chancre, treatmentmust be carried out as early as possible.

The main drugs used in treatment are antibiotics different groups and directions:

• penicillins;
• macrolites;
• tetracyclines;
• fluoroquinolones.

Together with antibiotics, the following are involved in the treatment process:

• antifungal drugs;
• immunomodulators;
• multivitamins;
• probiotics.

The treatment regimen for syphiloma is prescribed by the attending physician, based on the diagnosis and test results.

During the course of treatment, tetracyclines and drugs based on bismuth and iodine are added to penicillins. This complex of drugs can increase the effect of the antibiotic in the body.

If syphilis is diagnosed, both sexual partners are treated.

At the time of therapy, the patient is prescribed a diet whose diet is dominated by protein food and limiting the consumption of fats and carbohydrates.

During this period, smoking and drinking alcohol are contraindicated, and it is also necessary to reduce physical activity on the body.

Main condition quality treatment, this means observing the rules of personal hygiene and during the treatment period - not having sex.

It is necessary to treat chancroid with antibiotics:

• Extensillin - intramuscular injections, it is enough to carry out the procedure twice;
• Bicillin - injections, twice, every 5 calendar days;
• Erythromycin - 0.5 mg taken 4 times a day;
• Doxycycline - 0.5 mg taken 4 times a day.

For local treatment chancre, lotions on the chancre are needed with benzylpenicillin and dimexide.

It is necessary to lubricate the syphilitic chancre with heparin ointment, erythromycin ointment, ointment based on mercury and bismuth. Syntomycin ointment and levorin ointment help remove pus from the ulcer.

Chancres that are in the mouth must be rinsed with solutions:

• furacillin;
• boric acid;
• gramicidin.

Chancre is a very important sign in recognizing syphilis in the body. The earlier an infection is detected in the body, the faster treatment of the disease will begin, and the duration of the course of drug treatment may be minimal. In this case, treatment folk remedies and self-medication are contraindicated.

Only a competent doctor can diagnose and prescribe necessary treatment. Compliance with all doctor's instructions, healthy image life, maintaining hygiene will give a positive result in curing syphilis at the first stage of the disease.

Chancre is a symptom of primary syphilis, which is the most common manifestation of this disease. The disease has been known since the 15th century and in some periods of history caused serious epidemics in European countries. After the discovery of penicillin and the active introduction of antibiotic therapy, the prevalence of chancroid decreased significantly in all developed countries. Today, syphilis occurs in only 50 cases per 100,000 population, but 100 years ago this figure was 20–50 times higher.

Forms of chancre

There are several ways to separate chancre. IN international classification diseases of the 10th revision (ICD 10) it is proposed to distinguish it by location on the patient’s body:

• chancre of the genital organs;
• chancre of the anal area;
• chancre of other localizations.

A separate form of primary syphilis is distinguished, in which chancroid does not develop and the patient has no clinical symptoms of the disease.

There is also an older morphological classification of this pathology. It is based on appearance education. According to it, they distinguish:

• typical chancre;
• chancre felon; it develops on the fingertips (it is often confused with staphylococcal infection nail plastic);
• sore throat-like chancre; it occurs when the mucous membrane of the tonsil is damaged, manifested by its enlargement without the formation of ulcers or erosion.

Indurative edema often accompanies chancroid in women.

Causes of chancroid

Infection with Treponema pallidum (one of the types of gram-negative spirochetes) leads to the development of chancre. Most often it occurs during sexual intercourse, which is why syphilis is classified as a sexually transmitted disease.

The pathogen can also be transmitted through blood. In this regard, patients who require blood transfusions are at risk. Thanks to modern methods diagnosis of primary syphilis, the likelihood of infection by this method is minimal today. More high risk injection drug addicts who use one syringe are susceptible. It is also possible to transmit Treponema pallidum from mother to child during pregnancy.

IN living conditions Infection is possible through close contact with a patient, using his linen, hygiene products, and utensils. Treponema pallidum in saliva can cause the development of the disease in the presence of hard chancre in the oral cavity (for example, when kissing).

Hard chancre can be localized on the fingertips (due to hand touching the elements of primary syphilis).

Also at risk are medical workers, especially with insufficient compliance with antiseptic rules.

Treponema pallidum easily passes through mucous membranes (even intact ones). The frequency of infections during sexual intercourse is determined not only by the localization of chancre, but also high probability injury skin. Reacts immediately to pathogen penetration the immune system human, the purpose of which is to localize Treponema pallidum in the area of ​​primary infection. Cellular mechanisms are activated, which provokes the development of local specific inflammation. Treponema pallidum has developed defense mechanisms that do not allow it to be destroyed by phagocytes. This is a factor contributing to the chronicity of the disease.

Signs of chancroid

A chancre is a dense formation on the skin with erosion on the surface. Its edge is usually smooth, and the surface is covered with secretions that give a shiny hue. Elements appear on the skin or mucous membranes of the genitals, groin area, anus and inner surface hips Due to trauma during infection, several hard chancre may develop at once. All formations remain painless. Enlarged local lymph nodes can often be palpated around them.

Typically, chancre protrudes several millimeters above the surface of the skin. The development of the tumor is quite slow. In the absence of adequate treatment, it can remain for about 1–2 months in a practically unchanged state, after which it is destroyed.

Symptoms of chancroid can go unnoticed for a long time. General health the patient remains virtually unchanged. Quite often, hard chancroid in women is diagnosed accidentally when external inspection when visiting a doctor regarding another pathology. Mild discomfort in the area of ​​development of chancre is possible, which is due to local inflammation lymphatic vessels and nodes (lymphadenitis and lymphangitis).

Chancroid felon is characterized by the appearance of a club-like deformity distal phalanx fingers, their soreness and severe swelling. Enlarged regional lymph nodes in the elbow area often help identify this form of chancre.

A chancre is a dense formation on the skin with erosion on the surface.

When localizing primary lesion in the oral cavity or oropharynx, symptoms of chancroid are often observed, which are similar to acute tonsillitis:

• asymmetric enlargement of the tonsil;
• painful sensations when swallowing;
• feeling of a lump in the throat.

If this is accompanied by pronounced indurative swelling of the tissues, then the patient will also complain of difficulty breathing, especially during physical exertion.

Diagnostics

Diagnosis of chancroid begins with a history. Based on the results of examining formations on the skin or mucous membranes, a preliminary diagnosis of primary syphilis can be made. To confirm it, a number of specific laboratory tests are carried out.

With chancroid there are usually no deviations from the norm in general and biochemical analysis blood (except for cases of secondary bacterial infection). Instrumental studies(ultrasound diagnostics, computer or magnetic resonance imaging) can only show signs of regional inflammation of the lymph nodes.

Specific laboratory tests for diagnosing chancroid are divided into treponemal and non-treponemal. The latter are most often used for primary diagnosis diseases. These include:

• The Wasserman reaction is the historical first test for syphilis, which is now practically not used (it often gave a positive result in other pathologies).
• RPR test (Rapid Plasma Reagins) – anticardiolipin test. The test is used to screen for pathology in the general population in most Western countries.
• VDRL test (Venereal Disease Research Laboratory) - used to diagnose chancroid in Asian countries. Quite often gives false positive results.

Treponemal laboratory tests are used to make a definitive diagnosis of chancroid. They are highly specific, but they are also more expensive. These include:

• FTA-ABS test (immunofluorescent analysis) - specific antibodies to Treponema pallidum are used, which practically eliminates the possibility false positive result. This study is the gold standard for diagnosing primary syphilis in many European and American clinics. It is based on its results that the effectiveness of therapy is monitored.
• Immunoblotting is based on the detection of specific antibodies in the blood using electrophoresis and an enzyme-linked immunosorbent reaction.
• Polymerase chain reaction(PCR) – it requires a sample of the affected tissue or blood. Used in complex diagnostic cases. The result of the test is the form of the gene type of the causative agent of the disease.

Treatment

Infection with Treponema pallidum (one of the types of gram-negative spirochetes) leads to the development of chancre.

Treatment of chancre necessarily includes antibacterial agents. Just like 50 years ago, penicillin and its synthetic analogues. The standard treatment regimen includes a twenty-day course intramuscular injection benzylpenicillin or its analogue with a longer duration of action - bicillin-5.

If there are contraindications to prescribing drugs penicillin series(for example, in case of hypersensitivity), as well as resistance to them, treatment of chancroid is carried out with antibiotics of other groups - macrolides, cephalosporins or tetracyclines.

The effectiveness of the treatment can be monitored by the dynamics of regression clinical symptoms diseases. With effective antibiotic therapy, chancre in men and women quickly heals, and only a small scar remains in its place. Cure from syphilis must be confirmed by specific laboratory research(FTA-ABS test) at the end of the course of therapy.

Possible complications

The following are distinguished: possible complications chancre:

• Development of secondary and tertiary syphilis (in the absence of adequate treatment).
• Attachment of a secondary bacterial or fungal infection; in such cases, the symptoms of complications come to the fore.
• Development of phagedenism; This complication of chancroid is manifested by the development of gangrene.
• Development of paraphimosis; it occurs when the head of the penis is pinched by the skin of the foreskin and is accompanied by severe pain and difficulty urinating.
• Development of phimosis; chancre in men can lead to cicatricial narrowing of the foreskin.

Features of chancre in pregnant women

The clinical picture of chancroid in pregnant women is almost identical to that in other groups of patients. However, in this case, syphilis is dangerous due to its complications for the fetus - the development congenital form disease that has more severe course than in adults.

Treponema pallidum can pass through the placental barrier, which is the cause of congenital syphilis. It is characterized by damage to most systems and organs, tissue degeneration and developmental defects. In the absence of adequate therapy, pregnancy may be terminated prematurely.

Prevention measures

There is no specific prevention in the form of a vaccine against primary chancre. Most effective method avoid infection - no casual sex and use barrier methods contraception. It has been proven that using a condom during traditional sexual intercourse, while maintaining its integrity, greatly reduces the risk of contracting syphilis.

People at risk (especially medical workers who come into contact with patients) must practice good hygiene. When diagnosing primary chancre in a patient, a circle of people with whom he had sexual relations is established for prophylactic antibiotic therapy.

In order to detect the disease, all hospitals screen incoming patients. Syphilis test included mandatory list studies during pregnancy in most countries of the world.

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Is pretty dangerous disease which is sexually transmitted. One of primary signs The disease can become syphilitic chancre. This benign neoplasm appears on the human body after a few weeks of illness. In the absence of proper treatment, syphilitic chancre can turn into erosion.

Types of syphilitic chancre

There are many characteristics that describe chancre in syphilis. Depending on the criterion, several classifications and types of chancre are distinguished. Depending on the depth of the skin lesion, ulcerative (rather deep) and erosive (less deep, located on the surface of the skin) are distinguished. Chancres can be located in a single specimen, or they can be represented by entire groups of neoplasms.

The size of chancre with syphilis may vary. There are the following sizes of neoplasms associated with sexually transmitted diseases:

• Dwarf (size does not exceed one centimeter);
• Medium (size can reach two centimeters);
• Giant (can grow up to five centimeters in diameter).

Not many people know that a disease such as syphilis can cause the appearance of hard and chancre. You need to know what chancre looks like. It is this that occurs as the primary symptom of syphilis. Chancroid can affect almost all areas of the human body.

His distinctive characteristic is geometrically correct area on the skin with a whitish film on top. This film contains a huge variety of syphilis pathogens.

Syphilis can develop atypical forms chancre:

• Chancre felon. This type of chancre is located in the area of ​​the hands and fingers. Quite often chancres on the index and thumbs hands appear among gynecologists and surgeons as occupational disease. Panarcium is a rather painful neoplasm;

• Chancre amygdalitis. Chancres of a similar nature appear on one of the tonsils in the throat of a person with syphilis. A neoplasm of this type practically does not hurt and does not bother a person. The only difference is that the affected tonsil is significantly different in size from the healthy one. Chancroid amygdalitis can affect the health of the pharynx;

• Indurative edema. This tumor appears on the genitals of women and men. The tissues of the genital organs become denser, swell and increase in size. In this case, there are no unpleasant or painful sensations.

The first signs of the appearance of syphilitic chancre

Syphilis is a dangerous disease not only for health, but also for human life. If left untreated, the disease progresses to chronic form, constantly torments the patient with remissions until it leads to fatal outcome. The bacteria that causes syphilis cause symptoms of the disease. As a rule, they appear two to three weeks after infection.

Chancre can appear in the following areas of the human body:

• Genital organs. The appearance of chancre on the genitals of a person infected with syphilis is most common. The causative agent of both the main disease and its consequences is treponema pallidum. Transmission of the pathogen occurs through sexual contact with a carrier. If there is already damage to the genitals of a woman or man, the pathogen quickly penetrates it and forms a chancre in a few weeks;

• Large skin surfaces. Giant syphilitic chancre, which reaches five centimeters in size, is most often located on the hips, back and abdomen. They grow quite quickly and spread throughout the body and can form entire groups of neoplasms;
• Hands and fingers. Neoplasms of a sexually transmitted nature on the hands occur quite rarely. Most often, their appearance is provoked by infection not through sexual contact, but by working directly with the pathogen. Doctors and laboratory assistants who work closely with infected people and their biological material are at risk for this course of the disease.

In rare cases, syphilitic chancre may appear on the mucous membrane, on the face and other parts of the body.

Visual signs of chancre

The period from the appearance of the first signs of a neoplasm to the formation of a full-fledged chancre can be about a month. In very rare cases, the first signs of the disease appeared seven to ten days after treponema entered the human body. On the contrary, a long absence primary symptom may provoke the use of antibiotics, which kill some bacteria or slow down their activity.

The process of formation of syphilitic chancre:

• Hard syphilis chancre forms two to three weeks after the start of treponema activity in the human body;
• Regional scleradenitis develops. It is characterized by the following symptoms:

1. The appearance of small formations in the area of ​​the lymph nodes, which are located near the chancre;
2. On palpation, the formations have a heterogeneous structure and are quite dense;
3. The nodes may move under the skin when exposed to pressure;
4. One of the nodes is usually larger than all the others;
5. The skin in the area of ​​nodule formation does not change.

A few weeks after the formation of the chancre, a test for syphilis can be performed. Serological reaction if there is a pathogen in the body, it will be positive.

Visually, syphilitic chancre can be compared to a circle. It has dense and smooth bases. Its edges completely coincide with geometric figure. At visual assessment chancre is distinguished by its similarity to nodules and small cartilages. When located on areas of the body covered by clothing, the chancre has a bright red or slightly purple tint. Constant contact with external environment causes chancre to darken to brown.

The neoplasm that causes primary syphilis is no different specific symptoms. It does not hurt, does not itch, or causes any discomfort. In many cases, the symptom of a “crying chancre” is present. In this case, the release of a cloudy dense liquid is observed when external influence on chancre

Treatment of syphilitic chancre

Before starting treatment, you need to know that chancre is a condition that is not an independent disease, but only a symptom of syphilis. Its appearance is caused by a disease that needs urgent treatment.

Chancre is the primary manifestation of the disease. If left untreated, it can develop into a painful ulcer and cause infection throughout the body and eventually death.

Chancres must be treated with an antiseptic every day to prevent secondary infection from occurring on damaged skin. To do this, any antiseptic liquid is applied to a sterile bandage and attached to the formation on the skin. Giant chancre can be washed and then wrapped in a bandage.

When treating a disease it is necessary to use complex preparations, which allow you to get rid of the cause and remove the symptoms of the disease. The treatment includes the following drugs:

• Antibacterial ointments and gels;
• Injections and injections of drugs against syphilis.

The mainstay of treatment for syphilis is antibiotics. At venereal diseases Oxacillin, penicillin and ampicillin can be used. At proper treatment small chancrees completely disappear after two weeks of antibiotic use, giant ones - after a month.